CPT code 96423: Chemotherapy infusion, intra-arterial, each additional hour2026 Medicare rate & RVUs

Medicare pays $75.49 for 96423 nationally in the office. Local office rates run $65.07–$105.45.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 96423 covers

This add-on service covers continued delivery of a chemotherapy agent through an artery after the initial intra-arterial infusion period. It is used in oncology care when treatment is administered through an arterial catheter rather than by intravenous infusion, injection, or a prolonged pump. Oncology clinicians and qualified staff may perform the administration in an outpatient or hospital setting, with the service furnished under physician supervision as an incident-to service.

Report 96423 with the primary intra-arterial infusion service, 96422; it is not a stand-alone administration code. Assign units from documented infusion duration and follow the applicable CPT time instructions. The record should identify the drug, route, infusion start and stop times, and the total time supporting the additional-hour unit or units. CMS classifies this as an add-on code paid within the primary procedure's global period, and permits billing only when performed under physician supervision.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 96423 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96423 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 96423 rate is calculated

Each of 96423’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 96423

The CMS indicators that decide how 96423 is paid alongside other services.

96423 compared with similar codes

How to choose

96422Arterial infusionUp to one hour

96422 represents the primary intra-arterial infusion service for the initial period; 96423 is reported only for supported additional infusion time.

96415Chemo infusion add-onEach additional hour

Both represent additional chemotherapy infusion time, but 96415 is for intravenous administration and 96423 is for intra-arterial administration.

96420Chemotherapy pushIntra-arterial route

96420 describes intra-arterial chemotherapy delivered by push technique; 96423 is for additional time in an infusion.

96417Chemotherapy infusionAdditional sequential drug

96417 concerns an additional sequential chemotherapy infusion, while 96423 accounts for additional time in the intra-arterial infusion service.

Codes related to 96423

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates